Distinct transcriptomic features are seen in North American ATLL. (A) Unsupervised clustering analysis of RNA-seq profiles of healthy CD4 controls and ATLL samples. (B) Volcano plot shows aberrantly expressed genes in North American ATLL compared with healthy controls. (C) Supervised clustering analysis reveals genes that are aberrantly expressed in North American ATLL. (D) Functional pathways enriched in differentially expressed genes. (E) Unsupervised clustering based on RNA-seq profiles shows transcriptomic differences between Japanese (blue, n = 57) and North American (orange, n = 9) ATLL samples.